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Surgery > 100 clinical surgical vignettes > Flashcards

100 clinical surgical vignettes Flashcards

1
Q

Elderly woman, SBO, and air in biliary tree

A

gallstone ileus

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2
Q

elderly woman w/ pain down inner aspect of thigh

A

Obturator hernia

Howship-Romberg sign

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3
Q
  • Abdominal pain
  • Hypotension
  • Pulsating abdominal mass
A

AAA rupture

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4
Q

Abdominal pain “out of proportion” to abdominal exam

A

Mesenteric ischemia

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5
Q

arm pain and syncope with arm movement

A

subclavian steal syndrome

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6
Q

increasing creatinine while on ACEI

A

Renal artery Stenosis

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7
Q

child with midline neck mass

A

thyroglossal duct cyst

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8
Q

child with lateral neck mass

A

branchial cleft cyst

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9
Q

crush injury and dark urine

A

myoglobinuria

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10
Q
  • Vomiting
  • Chest Pain radiating to back
  • Mediastinal air
A

Boerhaave’s

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11
Q

Lower GIB + technetium pertechnetate scan

A

meckels diverticulum

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12
Q
  • Flushing
  • Diarrhea
  • Right sided HF
A

Carcinoid

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13
Q

Pneumaturia and LLQ pain

A

colovesicular fistula

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14
Q
  • Desmoid tumor
  • Osteoma
  • Colon cancer
A

Gardner’s syndrome

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15
Q

Epigastric pain radiating to back and flank ecchymosis

A

Hemorrhagic pancreatitis

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16
Q

pancreatitis and palpable epigastric mass

A

pancreatic pseudocyst

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17
Q
  • RUQ pain
  • Travel
  • Exposure to sheep
A

Hydatid cyst

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18
Q

Caput medusa

A

portal HTN

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19
Q

45 year old woman with RUQ pain for 12 hours, fever, and leukocytosis

A

Acute cholecystitis

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20
Q

Elderly man with large contender palpable gallbladder

A

Pancreatic cancer (Courvoisier’s sign)

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21
Q

Female taking birth control. pills with liver mass

A

Hepatic adenoma

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22
Q

liver tumor with “central scar”

A

focal nodular hyperplasia

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23
Q
  • Pancreatic mass
  • Gallstones
  • Diabetes
  • Diarrhea
A

Somatostatinoma

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24
Q

RUQ bruit and CHF in young adult

A

liver hemangioma

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25
Q

excruciating pain with bowel movement

A

anal fissure

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26
Q

Liver abscess with “anchovy paste”

A

amebic abscess

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27
Q
  • Abdominal pain
  • Diarrhea
  • Anal fistulae
A

Crohn’s disease

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28
Q

EKG with Peaked T waves

A

Hyperkalemia

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29
Q

Buccal mucosa with pigmentation

A

Peutz-Jeghers syndrome

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30
Q
  • LLQ pain
  • Fever
  • Change in bowel habits
A

Diverticulitis

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31
Q

Elevated urine 5-HIAA

A

carcinoid

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32
Q
  • Institutionalized
  • Abdominal pain
  • Vomiting
  • Distention
  • Proximal colonic dilation
A

Sigmoid volvulus

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33
Q

Newborn with failure to pass meconium in first 24 hours

A

Hirschsprung’s

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34
Q

infant with bilious vomiting

A

malrotation

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35
Q

infant with projectile vomiting

A

pyloric stenosis

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36
Q

newborn with abdominal defect and umbilical cord on sac

A

omphalocele

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37
Q

teenager with knee pain and “onion skinning” on X-ray

A

Ewing’s sarcoma

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38
Q

PCWP <16, CXR with bilateral pulmonary infiltrates, PaO2:FiO2 ratio < 300

A

ARDS

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39
Q
  • Increased peak airway pressure
  • Low UOP
  • Urinary bladder >25 mmHg
A

Abdominal Compartment syndrome

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40
Q

Newborn with inability to “pass an NGT”

A

Esophageal atresia

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41
Q

traumatic blinding in one eye followed by blindness in the contralateral eye 2 weeks later

A

sympathetic ophthalmia

42
Q
  • Miotic pupil
  • Ptosis
  • Anhydrosis
A

Horner’s syndrome

43
Q
  • Traumatic head injury

- Conscious in ER followed by unconsciousness

A 
Epidural hematoma 
(lucid interval)
44
Q

“Worst headache of my life”

A

subarachnoid hemorrhage

45
Q
  • Hematuria
  • Flank pain
  • Abdominal mass (palpable)
A

Renal cell carcinoma

46
Q

60 year old White Man with Painless Hematuria

A

bladder cancer

47
Q
  • RUQ pain
  • Jaundice
  • Fever
A

Cholangitis

48
Q
  • Epigastric pain radiating to back

- N/V

A

Pancreatitis

49
Q

Chest pain radiating to back and described as a “tearing” pain

A

Aortic dissection

50
Q

40 year old Man with Tachycardia/HTN and confusion on POD#2

A

Alcohol withdrawal

51
Q

Marfanoid body habitus and mucosal neuromas

52
Q

Psammoma bodies

A

papillary thyroid cancer

53
Q

sulfur granules

A

Actinomyces infection

54
Q

Thyroid tumor with AMYLOID tissue

A

Thyroid medullary cancer

55
Q

PALPABLE neck tumor and hypercalcemia

A

Parathyroid cancer

56
Q
  • HTN
  • Sweating
  • Palpitations
A

Pheochromocytoma

57
Q

Jejunal ulcers

A

Zollinger-Ellison syndrome

58
Q
  • Pituitary tumor
  • Pancreatic tumor
  • Parathyroid tumor
59
Q

Necrotizing migratory erythema

A

Glucagonoma

60
Q
  • Medullary thyroid cancer
  • Pheochromocytoma
  • Hyperparathyroidism
61
Q

Hypokalemia refractory to IV potassium supplementation

A

Hypomagnesemia

62
Q

Newborn with pneumatosis

A

Necrotizing enterocolitis (NEC)

63
Q

child with abdominal mass that crosses midline

A

Neuroblastoma

64
Q

child <4 years old with abdominal tumor that does NOT cross midline

A

Wilms’ Tumor

65
Q

“Currant jelly” stools and abdominal colic

A

Intussusception

66
Q
  • Femur fracture
  • Respiratory failure
  • Petechiae
  • AMS
A

Fat embolism

67
Q

Hearing loss + Tinnitus + Vertigo

A

Meniere’s disease

68
Q

Adolescent boy with nasal obstruction and recurrent epistaxis

A

Juvenile nasopharyngeal angiofibroma

69
Q

Child <5 yr old sitting upright and drooling, with “Hot-potato” voice

A

Epiglottitis

70
Q
  • Angina
  • Syncope
  • CHF
A

Aortic stenosis

71
Q
  • Tobacco use
  • Asbestos exposure
  • Pleuritic chest pain
A

Mesothelioma

72
Q

Supracondylar fracture and contracture of forearm flexors

A

Volkmann’s contracture

73
Q
  • Tibia fracture*
  • “Pain out of proportion”
  • Pain on PASSIVE foot movement
  • Palpable pulses
A

Compartment syndrome

74
Q

25 yr old man with liver mass with fibrous septa and NO history of cirrhosis or hepatitis

A

Fibrolamellar hepatocellular carcinoma

75
Q

EKG:

  • Flattening of T waves
  • U waves
A

Hypokalemia

76
Q

Central pontine myelinolysis

A

Too rapid correction of hyponatremia

77
Q
  • Polydipsia
  • Polyuria
  • Constipation
A

Hypercalcemia

78
Q

Factor VIII deficiency

A

Hemophilia A

79
Q
  • Abdominal pain
  • Fever
  • Hypotension
  • HYPERkalemia
  • HYPOnatremia
A

Adrenal insufficiency (Addisonian crisis)

80
Q

Massive UOP and HYPERnatremia

A

Diabetes insipidus

81
Q
  • Increased urine osmolality
  • HYPOnatremia
  • Low Serum osmolality
82
Q

IV ABX, fever, diarrhea

A

C. diff colitis

83
Q

Bleeding gums and wound dehiscence

A

Vitamin C deficiency

84
Q
  • Fever
  • Central line
  • HYPERglycemia
A

central line infection

85
Q

Appendectomy followed by fever and abdominal pain on POD#7

A

Peritoneal abscess

86
Q
  • Advancing crepitus
  • Fever
  • Blood blisters
A

Necrotizing fasciitis

87
Q

high INTRAoperative fever

A

malignant hyperthermia

88
Q
  • Confusion
  • Ataxia
  • Ophthalmoplegia
A

Wernicke’s encephalopathy

89
Q
  • Tracheal deviation
  • Decreased Breath sounds
  • Hyperresonance
A

Tension PTX

90
Q
  • Hypotension
  • Decreased heart sounds
  • JVD
A

Pericardial Tamponade

91
Q

Four ribs broken in two places and pulmonary contusion

A

flail chest

92
Q

Otorrhea (clear) and Battle’s sign

A

Basilar skull fracture

93
Q

Ulcer and decreased pain with food

A

Duodenal ulcer

94
Q
  • Vomiting
  • Retching
  • Epigastric pain
A

Mallory-Weiss tear

95
Q

Fever on POD#1, with “Bronze” weeping, tender wound

A

Clostridial wound infection

96
Q

Hematochezia and tenesmus

A

Rectal Cancer

97
Q
  • Upper GIB
  • Jaundice
  • RUQ pain
98
Q
  • Gallstones
  • Epigastric pain radiating to back
  • Nausea
A

Gallstone pancreatitis

99
Q

18 yr old woman with Bloody nipple discharge

A

Ductal papilloma

100
Q
  • Irritability
  • Diaphoresis
  • Weakness
  • Tremulousness
  • Palpitations
A

Insulinoma

Surgery (7 decks)

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